Provider Demographics
NPI:1548269871
Name:MORGAN, GREGORY (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5816 POPPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-1657
Mailing Address - Country:US
Mailing Address - Phone:402-556-4725
Mailing Address - Fax:308-532-6964
Practice Address - Street 1:300 E 3RD ST RM 302
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-4026
Practice Address - Country:US
Practice Address - Phone:308-532-6906
Practice Address - Fax:308-532-6964
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS423688207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSE54732Medicare UPIN
KS103088Medicare PIN